Richard George Wagner Jr., M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD40355 Issued in SC

Practice address

519 Ocean Blvd
Isle of Palms, SC 29451-2132

Phone

(404) 735-1730

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Medical Associates of the Medical University of South Carol

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment NPD
• University Medical Associates of the Medical University of South Carol

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1013934629

  Pediatrics

  NPD
• University Medical Associates of the Medical University of South Carol

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1750380499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 OCEAN BLVD",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "294512132",
            "telephone_number": "404-735-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 OCEAN BLVD",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "294512132",
            "telephone_number": "404-735-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "RICHARD",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "MD40355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Sledden, RDN, LDN
• Teeth DS Isle of Palms
• Teeth DS Isle of Palms
• The Island Doctor
• Tide Life Therapy LLC
• Lindsay Williams, ED.S.

• Pediatrics Physician in Isle of Palms, SC
• Providers in Isle of Palms, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.